Tuesday, December 27, 2005

Bathroom Privacy

If you are with my family, and you feel as though you are going to say something very, very rude, do not go into the bathroom. Do not, I beg you, go into the bathroom shut the door, and enjoy several comment free moments. Because, if you spend more than the Correct allotted Time you will then be faced with every single person asking you about your bowel habits, or telling you about theirs. Did you know that pepperoni give mom gas, and diarrhea? Did you know that there are those among you who suffer from constipation? Did you know that there are others in the party who feel that rich food is just not worth it? Did you want to know?

I'm just sayin'.

Thursday, December 22, 2005

In Which Son Two Smashes His Thumb

Son One and Son Two were vigorously debating whether the door should be open or closed, and Son Two smashed his thumb in the Door. I, of course, was not home, not that my husband was doing anything wrong, but still. I was actually at the dentist having a root canal. Did you know that there are people who cannot be properly numbed by novicaine? You do now. I spent the entire two hour appointment with the tears leaking into my ears and holding my own hands down. The chirpy receptionist came in and asked how much longer we would be, as my husband was on the phone and thought my son had a broken thumb. Note: this is a good way to split without paying your co-pay.

So, we trooped off to my very own hospital and had it x-rayed. Note: the PICU nurses are not well known in the ED, and we did not receive any extra love. No un-love, just no love. The radiologist will read the x-ray in the morning, and in the meantime, he has no obvious fracture. But he is three, and he said to me "Mommy, the ban-aid is not working" meaning it was still hurting. I, who spend a lot of my professional life sticking children with needles and otherwise causing them grief, was moved to tears.

We are home now, and he has had a dose of Tyco (tylenol with codeine) and I have suddenly realized that my mouth hurts.

While I was at the hospital, I realized that I have a Pavlovian connection between Diet Coke and being in that building. I began craving the Diet Coke as soon as I passed through the metal detector and was not able to not think of it for more than a few minutes the whole time we were there. Everytime we made a move- from ED to x-ray, from x-ray to the ED, then over to the cast room, I was calculating if we would pass the vending area, and fretting that I had only a $20 in my pocket, and thus would need to get change. I got home and downed two cans.

Tuesday, December 20, 2005

Lazy is as lazy does

I need to cultivate my laziness, obviously. I came in to a bust ass assignment, another nurse with a B.A. assignment, and the Co- worker from Hell who had a single, settled patient who would have been out of ICU and on the floor except that the floor was swamped. Ahem. In the first two hours of my day, I drew central and peripheral blood cultures on a screaming fighting BITING child who was small, but mighty. ( No sympathy from nurses who care for adults, I know, but, still. He BIT me.) Then I drew a few more labs that the oncoming doc wanted. Then I noticed that my other patient hadn't had his morning x-ray, and gee, seemed to have lots 'o clonus and weird over all tone, plus a tendency to sort of drift off and stop breathing. He gets a neuro consult and a stat CT of his head, and mom of said baby is crying and crying and crying. Both patients are on triple antibiotics, so timing is tight, both only have one IV and no real hope of getting another without a central line.

Kid number one, the biter- ( actually, I admire his spirit. He is like a little David going against the incomprehensible giants. I mean, he's had a brain insult, he's two, and people keep poking him)- begins to vomit. A dire sign in our neuro unit. Plus, I get the happy task of pointing out to the docs that they were not notified last night when the patient was spiking a temp, although the nurse who took the temp did write it down on the chart. Luckily for Biting David, he was not septic and dead within the hour, but we're still very worried about him. We discover that grandma made him eat breakfast before she left, and then when mom couldn't find his breakfast tray, she went to the cafeteria and bought him breakfast, which he ate, and you just can't fit that much mother love into one tummy. Too much tummy pressure, not head pressure. I change the bed and go about my business.

Lazy co- worker has given pain meds once. She is reading People magazine at the desk.

While I am down in CT with the baby, who is obligingly breathing on his own while off the unit, another nurse comes in. Lazy nurse declares herself charge nurse. I come back, and she:
a) helps me settle my patient and reassures mom of patient
b) volunteers to stick little Biter for the new labs that ID has ordered STAT
c) takes her ass to lunch

If you have been following along you have chosen "c" which, although it is the wrong thing to do, is the right answer to our little quiz. Nurse who has come in is a traveler who is not renewing her contract, and thus is reading her magazine at the desk.

Did I mention that there is no ward clerk, and that the phone rings incessantly?

Did I mention that there is another nurse with an assignment as bad or worse than mine?

Did I mention that I now seem to hate almost everyone over the age of twelve?

Monday, December 19, 2005

Poor Baby

Remember the baby? The one that I so cockily predicted would be fine in a few days? She was trying to die as I left today. Of course, I stayed late and watched the other patients untill things were settled. She is hovering around 88% O2 sat, and she is very very sick. There is no easy answer, here. There is no easy cure. This is RSV.

Knitting. Uhm, none? Maybe a little on the sleeve of the EPS before I fall alseep. Which I would like to do, soon.

THe picture? a sea anenome I met at Point Pilar.

Tuesday, December 13, 2005

They still die

But they are better deaths. Oncology, that is. The Oncology floor nurses do a great job on the end of life situations. I am planning on a transfer to that unit, when and if, a day shift job opens up. Of course, once I submitted transfer paperwork, my boss got very complimentary about my work. It will be a hard switch for me. The meds are hellishly complicated, precisely timed. And dangerous. The kids are all bald and swollen. The hope that the kids will live is like a flock of butterflies over the unit- so many more of them do live, now. Back when I was misdiagnosed with leukemia, in the early 1980's, it was a death sentence. Now, not so much. Lots of kids live to grow up, and isn't that what we all want?

But lets talk about me, here, because, after all, this is a blog. I will have to learn to take vital signs only every four hours. I will have to remember to bring their food trays. I will have to get used to awake alert, and oriented as the norm and not the exception. I will have to learn that I can get off my chair at the end of the bed and that the kid will still be alive without me staring at them, their monitor, and their drips. Plus, that flock of butterflies, each one a real hope of living to grow up.

Tuesday, December 06, 2005

Breathe, Baby

Breathe- that was my patient's task today, and she failed. All day, we did the oxygen ramp up- mask at 8 liters, Non rebreather at 8, then 10 liters. Non rebreather with albuterol- nope. NRB with racimic epi- nope. Meanwhile, Dr. Napoleon is strutting around asking who'd like to make a bet that the kid "eats some plastic" before morning. Blessedly, Dr N goes home and Dr Gestalt comes in. Dr G takes one look at my struggling, crumping patient and asks for Respiratory to bring a vent, X-ray to come for a stat portable chest x ray, and could I please draw up some versed, fentynl, and vecuronium? I do and a 4.0 cuffed endotracheal tube slides down nicely. She is now a paralyzed, sedated, intubated baby, and her sats are quite nice. If all goes well, she will heal, she will rest, and in three to four days she will be extubated, get better, and a few more days she will go home. I wish her mother knew all this, in the same way I do.

It is now, of course, well past the time I should be going home. The next nurse looked a bit overwhelmed, and why shouldn't she? My life was a no lunch, no breaks, no peeing kind of day. May she do it with more grace than I.

Knitting- uhmm. Haven't. I have a yen to crochet an afghan for Son Two's babysitter. Son One's teacher is getting a seaman's scarf.

Thursday, December 01, 2005

Blog Wall

Ohhh, I've done it! I've hit the wall on posting! Yes, I now officially feel that I have nothing to say. Not that that will stop me.

Infuriating day at work. Was asked by manager to attended a bi weekly meeting that focuses on reducing pressure ulcers , was enthusiastic about this. Then was told that I would have to change my schedule and attend on my day off, or, alternatively, count my attendance as my lunch and breaks. In any case, there is about four hours of work to do before the meeting so that the charts and patients are ready to be reported on. Every other floor has a manager that is doing this- and why not? Our corporate entity supports it, our hospital risk dept supports it, and it's the right thing to do. Its wrong to let sick people get bed sores. And yet, when I cheerfully bounced into my Evil Managers office to report on the meeting and ask for the out of staffing time to do a good job on this, I was absolutely shot down. Weird.

Also, The Nurse Who Does Nothing was forced to take care of my patients while I was at this meeting. He did, Nothing. No vital signs, no, turns, no meds, no nothing. ANd I'm the problem. I'm being harsh, here. I'm sure that if they had stopped breathing he would have bagged them. I think. NWDN comes in every day at 11, has no assignment untill 4, and really, does nothing. He has actually gotten a tear in his eye when forced to take an admit last week. I don't know how he does it.

Knitting- oh, hell. I've done nothing except a few useless rounds on the EPS sweater. I want to go to bed, but have to wait a few more hours untill Son One and Son Two come back from their wonderful afternoon activities with daddy. Then I can force them into bed and go myself. Sleep is wasted on the young.